OBJECTIVE To analyze the characteristic of pulmonary infection especially for the Pneumocystis carinii pneumonia(PCP) after kidney transplantation and discuss the effective control measures to reduce the infection rate.METHODS The prospective investigation was conducted among in the kidney transplant patients with pneumonia between Jan and Feb in 2004.and the retrospective investigation was conducted among the cases with kidney transplant from Jan 2003 to Dec 2004 and the characteristic of PCP with other kinds of pneumonia was compared.RESULTS Ninety two cases with kidney transplant from Jan 2003 to Dec 2004 were investigated,of which 19 patients(20.7%) had pneumonia,8 PCPs(42.1%) occurred.The median of PCP appearing time was 61days after the operation.CONCLUSIONS The pneumonia is the most familiar infection after the kidney transplantation.Prevention from the pneumonia after the kidney transplantation,especially PCP is the keystone to reduce the infection for the kidney transplantation.

OBJECTIVE:To provide reference for safe and effective use of anti-infective agents in the clinic. METHODS:The utilization of anti-infective agents in hematology department of our hospital from 2009 to 2013 was analyzed statistically using con-sumption sum,DDDs,the ratio of the serial number (the ratio of the serial number of consumption sum to the serial number of DDDs),DDC. RESULTS:There were 5 kinds of anti-infective agents,such as β-lactam and its compound preparations,antifungal drugs,fluoroquinolone and glycopeptide. From 2009 to 2013,the percentage of anti-infective agents with the ratio of serial num-bers≥1 were 70%,60%,70%,60%,65%,respectively. CONCLUSIONS:From 2009 to 2013,the utilization of anti-infective agents in hematology department of our hospital is rational on the whole. However,the cheaper drugs with good synchronism should be used.

OBJECTIVE To know the compliance and it′s impact factors of hand hygiene of healthcare workers.METHODS The wards and healthcare workers were sampled randomly.Survey the compliance,qualified rate and impact factors of hand hygiene of healthcare workers when they didn′t know to be observed by special training staffs.RESULTS The compliance and the qualified rate of hand hygiene was 30.2% bothly,and be affected by the time before or after operation,occupations and work post.The factors causing low qualified rate were anenough time and improper technique for washing hand,and drying hand wrong.CONCLUSIONS The hand hygiene for healthcare workers in hospitals should be strengthened.

Objective To investigate the expression level of thymus microRNA-27a-3p in patients with myasthenia gravis (MG) and to explore the pathogenesis of MG.Methods Thymus tissue samples from 36 cases were collected from December 2014 to February 2015 in the Second Affiliated Hospital of Harbin Medical University.Nineteen thymus tissue samples of MG group were collected from department of chest surgery,17 thymus tissue samples of control group were collected from department of chest surgery or congenital heart disease patients from department of cardiac surgery.The expression of microRNA-27a-3p in the thymus from 36 patients was determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR),using U6 as housekeeping control.The Wilcoxon Rank-Sum test was used to analyze the relative expression of microRNA-27a-3p of the two groups.Spearman rank correlation was used to determine the correlation coefficient between microRNA-27a-3p and Quantitative Myasthenia Gravis Score (QMGS).Results (1) The expression level of microRNA-27a-3p in thymus was significantly higher in MG group (0.195(0.049,0.714)) compared with control group (0.045(0.004,0.088),Z =-2.646,P =0.008).(2) Nineteen MG patients were included in the study,out of which 7 were ocular myasthenia gravis (OMG) patients and 12 were generalized myasthenia gravis (GMG) patients.The expression of microRNA-27a-3p in GMG patients (0.493 (0.157,1.123)) was significantly higher than that in OMG patients (0.035 (0.008,0.103),Z =-2.620,P =0.009).(3) There was a positive correlation between the expression of microRNA-27a-3p and QMGS (r =0.576,P =0.010).Conclusions The expression of microRNA-27a-3p in thymus is significantly up-regulated in the patients with MG.MicroRNA-27a-3p may be associated with MG severity and significantly elevated in GMG patients compared with OMG patients.

Objective To investigate the association between myasthenia gravis (MG) and single nucleotide polymorphisms (SNPs) of PTPN22 + 1858C/T,CTLA-4 (+ 49A/G;-1772C/T;-1661A/G),KRAS(rs9226),BCL2(rs4987855) and IGF-1R(rs34804698) genes.Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was adopted to detect the gene types of SNPs in 76 MG patients who were enrolled in the Second Affiliated Hospital of Harbin Medical University from July 2011 to June 2015 and 59 healthy blood donors.Results In MG patients,the frequences of CTLA-4 +49A/G(rs231775) (57.9％) and-1772C/T (rs733618) (43.4％) were higher than that in the healthy controls (22.1％) (x2 =35.252,P =0.000; x2 =4.098,P =0.043).The frequence of CTLA-4 +49A/G in MG patients combined with thymoma (25.6％) was higher than other subgroups (thymic hyperplasia group:13.8％; normal thymus group:18.4％)(x2 =7.564,P=0.006; x2 =7.155,P=0.007).Meanwhile,the frequence of the C-1772 allele was higher in thymoma group (19.7％) compared with other two groups (thymic hyperplasia group:9.86％ ; normal thymus group:13.8％) (x2 =5.331,P =0.021 ;x2 =4.411,P =0.036).However,the other SNPs were not associated with the risk of MG.Conclusion There are associations of MG with CTLA-4 + 49A/G and-1772C/T SNPs,but not with PTPN,KRAS,BC12 and IGF-1R SNPs.

OBJECTIVE To investigate the characteristic of multidrug resistant organisms(MDROs) in hospital or community-acquired infection,so that it can approach effective infection management.METHODS Patients infected by Staphylococcus,Enterococcus,Escherichia coli,Klpneumoniae and A.baumanni were investigated in a Hospital from June 2008 to May 2009.RESULTS Among total 929 strains of bacilli from patients,367 were MDROs infection,the detection rate of MDROs,CA-MDROs or HA-MDROs was 39.5%,35.6% and 51.4% respectioety infection;The detection rate of MDROs from HAI patients was significantly higher than that from CAI patients(?2=19.2 P=0.00).There were differences between HA-MDROs and CA-MDROs in different departments.MRSA,ESBLs-kp And PDR-AB were isolated mostly from sputum of patients,and ESBLs E.coli mostly from urine of CAI patients.CONCLUSIONS It is important to analyze the characteristic of HA-MDROs or CA-MDROs in the treatment of infection or use of antibiotics from experience.MDROs control is full of difficulties as a result of high CA-MDROs rates.

Objective To explore the relationship between left ventricular diastolic function and the dynamic changes of myocardial ultrastructure and argyrophilic fiber in diabetic rats on the different periods of lesions(week 4,12 and 24).Methods The diabetes mellitus(DM)in healthy male Sprague-Dawley rats was induced by a single injection of streptozotocin(STZ,Sigma)into intraperitoneal at a dose of 65 mg/kg body weight.The left ventricular diastolic function was measured by Color Doppler Flow Imaging-Pulsed Wave(CDFIPW)and Doppler Tissue Imaging(DTI)echocardiography.Heart tissue at the apex was obtained rapidly for transmission electron microscope study.Argyrophilic staining was used in the study of argyrophilic fiber volume fraction(APFVF)in heart interstitial tissue.Results Diastolic dysfunction of left ventricle was detected in STZinduced diabetic rats by CDFI-PW(E/A ＜ 1)at week 4,and progressed gradually.Pseudonormal filling (E/A ＞ 1)was found in diabetic rats at week 24,which could be identified by DTI(Ea/Aa ＜ 1).Diastolic function of normal rats was not impaired(E/A ＞ 1 and Ea/Aa ＞ 1).Transmission electron microscopy revealed a spectrum of subcellular remodeling in myocardium which was characterized by myofibril content decrease,disorganization,mitochondrial degeneration,sarcoplasmic reticulum,structural disorder.Compared with the control group,APFVF in myocardium was increased significantly in diabetic rats(P ＜ 0.05).Conclusion The diastolic dysfunction in STZ-induced diabetic rats correlates with damage of ultrastructure and increase of myocardial argyrophilic fiber.

OBJECTIVE To analyze the effect of the disposable over-shoes for the control of nosocomial infection of the intensive care units(ICU). METHODS The effects of the disposable over-shoes for the environment contamination and nosocomial infection control of the surgical ICU were investigated. RESULTS The mean of air bacteria colony counts when disposable over-shoes were worn was lower than that when without their use by healthcare workers (P0.05). The rates of nosocomial infection beteen them were 21.5‰ and 17.1‰,respectively. CONCLUSIONS The use of disposable over-shoes can't improve the environment quality and is not benefit for the control of nosocomial infection of surgical ICU.

Objective To evaluate the comprehensive medical goal appraisal system on hand hygiene compliance rate of health care workers(HCWs).Methods Comprehensive medical goal appraisal system was adopted to inter-vene hand hygiene compliance rate of HCWs in a comprehensive hospital ,hand hygiene compliance rates of HCWs and consumption of instant hand sanitizer per bed-day before (December 2012)and after intervention (January 2013-June 2014)were compared.Results Hand hygiene compliance rate after intervention was higher than before interven-tion (85.17% [18 208/21 379]vs 39.92%[853/2 137]),hand hygiene compliance rate enhanced by 113.35%(χ2 =2 590. 81,P <0.001).Hand hygiene compliance rates of HCWs of different departments,different occupations and different hand hygiene moments were all higher than before intervention (all P <0.001);after intervention ,hand hygiene compliance rate revealed a increased tendency,and has maintained high since October 2013 (>90%),consumption of instant hand sanitizer before and after intervention was 7.24 mL/bed-day(4 200 L/579 841 bed-day)and 10.54 mL/bed-day(9 323.5L/884 489 bed-day)respectively,the consumption after intervention increased by 45.58% compared with that before intervention. Conclusion Comprehensive medical goal appraisal can effectively enhance hand hygiene compliance rate ,and maintains at a high level;the measure can affect hand hygiene behavior of HCWs by hawthorne effect,and is an effective and long-term measure to improve hand hygiene compliance of HCWs.

Objective To improve hand hygiene (HH)compliance of health care workers (HCWs)in neonatal in-tensive care units(NICUs)in China through a series of intervention measures.Methods A multicenter study was conducted,17 tertiary first class hospitals in 9 provinces and cities were selected,HH compliance of HCWs in these hospitals were investigated every month according to HH investigation method of World Health Organization.From October 1 ,2013 to March 31 ,2014 was pre-intervention stage;from April 1 ,2014 to September 30,2014 was post-intervention stage,timely feedback and intensified training were conducted at post-intervention stage.Results HH compliance rates of HCWs before and after intervention were 80.29% and 80.85% respectively,there was no sig-nificant difference (P >0.05).HH compliance rates of HCWs in different sizes of ICUs were significantly different before and after intervention (all P <0.05),in NICUs with<20 beds and 20-30 beds after the intervention were both significantly higher than before intervention (both P <0.05 ),while >30 beds were significantly lower than before intervention(P <0.001 );HH compliance rate of cleaners increased from 58.82% before intervention to 68.09% after intervention (P <0.05 );Of different hand hygiene indications,except before clean/aseptic task, compliance to the other HH indications were significantly different between before and after intervention(all P <0.05).Conclusion HH compliance is high among HCWs in NICUs in China,intervention measures,such as inten-sified training and timely feedback have certain influence in compliance to HH among HCWs at different sizes of ICUs,of different occupations,and at different HH indications.